Skall jag gå, eller är det bättre att jag väntar? Förutsättningar för barns toalettbesök i skolan

Sammanfattning: Should I go, or is it better to wait? – Conditions for children to go to the toilet at school Barbro Lundblad The Sahlgrenska Academy at the UNIVERSITY OF GOTHENBURG, Institute of Health and Care Sciences Box 457, SE-405 30 Gothenburg, Sweden Abstract This thesis consists of four papers. It aims to describe the conditions children face when they need to go to the toilet in school, and the importance of these conditions to the children’s toilet habits. The results in paper I are based on a questionnaire answered by 385 school children. Content analysis was used analyzing the data from open-ended interviews in paper II - IV. Paper II and III were based on interviews with school children, and paper IV on interviews with teachers. The hygiene standards of school toilets were often poor and this affected the children’s toilet habits. The majority of children in paper I found the toilets unclean and perceived that the toilets smelled foul. Of the 385 children, 16% never urinated and 63% never defecated in the school toilet. Paper II showed that time in school was difficult for children who were treating functional bladder disturbances. The toilets seemed to be full of risks and they found it difficult to comply with the school rules and the urotherapist’s instructions. They struggled not to disclose that they suffered from bladder disturbances and put much effort into this. To maintain their wellbeing, they restrained their toilet needs. The children in paper III were seldom informed of the rules set by the teachers for toilet visits during class. They felt that they were expected to fulfil their toilet need during breaks, but the children were busy planning for their next lesson or did not feel the physical need to go. Children also calculated that the risk of being exposed on the toilet was high during breaks and this was one of the reasons they planned toilet visits during class. When they were in class they needed permission to go, and to get this most children had to raise their hand, wait for their turn to speak and then in front of all their classmates inform the teacher about their private toilet need. The view that it is important to go to the toilet when you feel the need or want to do so was shown to be widespread among the teachers in paper IV, as was the fact that the teachers based their attitudes on personal experience. The teachers in the study knew that children prefer go to the toilet during class for reasons such as anxiety and because they do not want to be disturbed during their visit. Most teachers had rules for toilet visits but did not convey them to the children. It was not seen as appropriate to go to the toilet when the teachers were teaching, going through work and during tests. In conclusion, these findings show that toilet conditions at school put children at risk. Perceptions of the toilets had a negative effect on children’s willingness to relieve themselves at school. School rules for toilet visits make it difficult for and can affect the wellbeing of children with bladder disturbances and children who want to keep their toilet needs private. Key words: children, school, teacher, toilet, habits, privacy, functional, bladder, bowel, disturbances, classroom, management, rules. The thesis is written in Swedish